Healthcare Provider Details

I. General information

NPI: 1669935011
Provider Name (Legal Business Name): SIRI SARVA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 SPRING ST STE 140
SILVER SPRING MD
20910-3616
US

IV. Provider business mailing address

1300 SPRING ST STE 140
SILVER SPRING MD
20910-3616
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number19075
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: